Making the Core and Pelvic Floor a Priority

I am not a licensed physical therapist or a certified personal trainer. The exercises in this post were recommended to me by a people who are. If you have weakness in your pelvic floor, imbalance in your hips or other running related injuries I would HIGHLY (Bold and italics AND all caps…that’s a lot.) recommend that you see a women’s health physical therapist who specializes in pelvic floor rehabilitation. Consider it an investment in yourself, your body and your future as a runner, a mother and a woman.

I am back on the rehab wagon with a vengeance after coming to the conclusion that strengthening my pelvic floor and core are essential to my running goals. All to often (like, every time) I set a running goal, I get very focused on my running and don’t make time for any strength training, stretching or foam rolling. Tightness builds and I don’t deal with it until I’ve had to stop running due to an injury.

I am just coming off a nine days of no running due to some tightness and pain in the joint of my big toe caused by weakness in my pelvic floor/hips. I eased into a run on Saturday with an easy three miles but pelvic floor and core work will remain my focus for the next few weeks the rest of my life. Here are some of the things I’ve been doing.

Pelvic Floor:

I continue to do the exercises from the Habit-It DVD and those prescribed by my physical therapist, Cristin Zaimes and have started to incorporate a Pilates DVD that I checked out from my local library. (Side note: the library is a great resource for fitness DVDs. I love that there is no commitment. I can check it out at no cost and if I really like it I can find it online and purchase it. I hate buying a fitness DVD and realizing that I hate the workout.) The Hab-It video is comprised of Kegels and exercises that strengthen the pelvic floor like bridge pose, clam-shells, leg lifts and much more. A lot of the exercises are the same as the ones that my physical therapist recommended with one big exception: she modified the full motion exercises with smaller, more concentrated motions. My PT was able to identify when I stopped using the correct muscles and started compensating for weakness with the “wrong’ muscles. It is easy for me to “power through” a lot of the motions especially the bridge pose: it isn’t hard to lift your hips off the ground. But what I couldn’t see was that after lifting a few inches my right hip dipped and “gave out” causing other muscles to compensate for the weakness. At a certain point I lost stability and engagement of the pelvic floor, multifidi and transverse abs and started compensating with larger muscles like my quads and hamstrings. My PT had me modify the motions: instead of doing a full bridge I was doing a quarter bridge so that all the correct muscle would be engaged. Same with a squat, she had me doing a quarter squat instead of a full squat so that I could learn to “turn on” the right muscles and keep them “on.” This is why I would recommend seeing a PT. Their eye is trained to see weakness and imbalance. I have a tendency to think that if I’m not working up a sweat I’m not having a “problem” with doing the exercise. But there were all kinds of “problems” with my bridge and squat and number of other exercises; there was weakness that I couldn’t detect.

As I do the Pilates DVD I try to be conscious of when the muscles of my pelvic floor/basket turn off. I pause the DVD, refocus and modify the movement until I can feel all the muscles turned “on” then I try it again a few times and re-start the DVD. I could easily power through all the pilates moves, but that would defeat the purpose. I need concentrated, quality movements that target the weakness in my hips and pelvic floor.

Core:

These two videos workouts were recommended by my sister and licensed physical therapist, Danielle. I’ve been doing these core workouts four or more times a week. I also slow down and modify the moves if I feel like I’m compensating for any weakness in the pelvic floor.

I’m not sure how long it will take to correct the imbalance in the my hip strength and my pelvic floor probably won’t be completely back to normal until I stop breastfeeding. My hope is that I can continue to run and strengthen at the same time, but the strengthening will have to take a priority because it supports the running.

I am a runner who had cronic piraformis discompfort since the birth of my 12 year old. I now have a 7 year old as well. Could never sit in a car for long periods of time… Constantly was managing it with the acue ball and trigger foam roller. Well being a trainer who specializes in PF health I thought I should get assessed as I was sending my clients PF assessments so I knew what their floor strength / health was before we trained. Well it was at that visit I found out I had stage 2 cystocele ( prolapse) UGH! How could that bee?? I never had symptoms of a weak PF or so I thought until I started doing the Hypopresive Method exercise program that has had my stage 2 prolapse eliminated as well as any sort of piraformis pain and disompfort. I went for a 4 hour car ride FDay weekend completely pain free!!! And I am not continuously trying to manage with piraformis and si problems. I have been to Spain to become a Hypopresive trainer and then to the UK for the adv certification. This method will revolutionize the fitness industry. For more about the method visit my sight and I will soon be featured on the Dr. Marla Shapiro show talking about the PF, Pelvic organ prolapse,PF dysfunction and the Hypopresive Mehod. Please feel free to email me with questions or if you would like to learn more.

If you haven’t spent some time reading Katy Bowman’s work, do it soon. (alignedandwell.com) She is a biomechanist with a passion for pelvic floor health. Her “Down There For Women” is a must app for anyone with pelvic floor issues. Here is a link to her blog pieces re: pelvic floor, but really all of her blog posts relate: http://www.alignedandwell.com/katysays/category/pelvic-floor/. I teach fitness to the postpartum and prenatal communities and her work has been a game-changer for the way I approach the “core.”

Thanks, I do read Katy Bowman and agree with everything I have read and love her writing style. It is the Hypopresive Method that has made such a big impact on the way I approach core strength and pelvic floor work. Here is a short segment of the Hypopresive method featured on the Dr. Marla & Friends show where I explain the method briefly and a client of mine is interviewed.http://www.ctvnews.ca/video?clipId=900200&playlistId=1.1227132&binId=1.969296&playlistPageNum=1
Dr. Marla and Friends: Part onehttp://www.ctvnews.ca
April 8: Dr. Marla discusses the different reasons for pelvic floor dysfunction and how to treat it naturally

I have read Katy Bowman’s work and love it! and the way she writes. I don’t disagree with what she says at all but I am a sworn believer in the Hypopresive Method and have seen and experienced a lot of success with this method. The method comes from Europe where it was developed by Dr. Marcel Caufriez in the 1980s. There are 6000 physios and 2000 trainers who have been using it in their practice for the past 30 years in fact it is part of the Belgium hospitals post natal protocol. This Hypopresive Method has been my game-changer for how I approach the core. Both approaches different but when one has such great success with a method it is hard not to promote it. The Hypopresive method has eliminated any signs of my stage 2 cyctocele while safely toning my abdominals and pelvic floor not to mention the wide variety of other benefits proven with this method. Here is just a short segment about the Hypopresive method with myself and a client if you are curious to learn about another approach. The more we learn I believe the more we are able to help others as not every approach is for everyone. http://www.ctvnews.ca/video?clipId=900200&playlistId=1.1227132&binId=1.969296&playlistPageNum=1

Run Far Girl, thanks so much for your great blog! I’m not a dedicated runner, but very interested in PF health and exercise after having my own PP struggles. So many women wonder whether they should run or not after PF birth trauma and your insights are very valuable.

Hi Sarah, I realise this blog post is from a few years ago but wonder if you would be able to tell me how you know when the correct muscle group is engaged when you are doing exercises such as a bridge and squat? I am also trying to incorporate lots of core strengthening exercises into my regime as I had a hamstring tendon issue during my half marathon training. I really hope to do a marathon one day and find your posts very inspiring. Thanks very much!

Hi Shona! I think the big thing is to do the movement very, very slowly. If you have one side that is weaker than another try to identify what in your strong side is “turning on” and duplicate that in the weak side. Go slow and only do the movement when you feel the muscles engaged, when the hamstring starter to “take over” stop and start again.

Thanks so much for your reply Sarah! That’s really helpful and I’ll do that tonight during my core session. I remember reading one of your posts where you had been injured and your core exercises really helped you to get back on track – that gives me lots of hope! Thanks again 🙂

[…] Cross-train and Strengthen Core. There will be no running if you don’t do these…or at least the running won’t be very pleasant. A weak pelvic floor and core can cause issues ranging from leakage to pain. It is essential to strengthen the muscles that were stretched and weakened during pregnancy and delivery. Most typical core workouts utilize the major muscles in the abdomen, make sure you target the smaller supporting muscles with little movements too. Your hips, core and pelvic floor are key. Here’s a some suggested core exercises. […]

[…] weeks postpartum with confidence, hoping to get a green light on running. I had been working on core and pelvic floor strength consistently since the birth of my son. And for the year prior to that I had made pelvic […]